Display options
Cite
Virgilsen LF, Pedersen AF, Vedsted P, et al. Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark. BMC Fam Pract. 2021;22(1):129doi: 10.1186/s12875-021-01480-2.
Virgilsen, L. F., Pedersen, A. F., Vedsted, P., Petersen, G. S., & Jensen, H. (2021). Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark. BMC family practice, 22(1), 129. https://doi.org/10.1186/s12875-021-01480-2
Virgilsen, Line Flytkjær, et al. "Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark." BMC family practice vol. 22,1 (2021): 129. doi: https://doi.org/10.1186/s12875-021-01480-2
Virgilsen LF, Pedersen AF, Vedsted P, Petersen GS, Jensen H. Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark. BMC Fam Pract. 2021 Jun 24;22(1):129. doi: 10.1186/s12875-021-01480-2. PMID: 34167486; PMCID: PMC8228922.
Copy Download .nbib Format: NLM
Share it on

BMC Fam Pract. 2021 Jun 24;22(1):129. doi: 10.1186/s12875-021-01480-2.

Alignment between the patient's cancer worry and the GP's cancer suspicion and the association with the interval between first symptom presentation and referral: a cross-sectional study in Denmark.

BMC family practice

Line Flytkjær Virgilsen, Anette Fischer Pedersen, Peter Vedsted, Gitte Stentebjerg Petersen, Henry Jensen

Affiliations

  1. Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark. [email protected].
  2. Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Bartholins Allé 2, 8000, Aarhus C, Denmark.
  3. Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus C, Denmark.
  4. Danish Cancer Society, Strandboulevarden 49,, 2100, København Ø, Denmark.

PMID: 34167486 PMCID: PMC8228922 DOI: 10.1186/s12875-021-01480-2

Abstract

BACKGROUND: General practitioners (GPs) have a key role in the diagnosis of cancer. It is crucial to identify factors influencing the decision to refer for suspected cancer. The aim of this study was to investigate the alignment between the patient's cancer worry and the GP's suspicion of cancer in the first clinical encounter and the association with the time interval from the first symptom presentation until the first referral to specialist care, i.e. the primary care interval (PCI).

METHOD: The study was performed as a cross-sectional study using survey data on patients diagnosed with incident cancer in 2010 or 2016 and their GPs in Denmark. We defined four alignment groups: 1) patient worry and GP suspicion, 2)  GP suspicion only, 3) patient worry only, and 4) none of the two. A long PCI was defined as an interval longer than the 75th percentile.

RESULTS: Among the 3333 included patients, both patient worry and GP suspicion was seen in 39.5%, only GP suspicion was seen in 28.2%, only patient worry was seen in 13.6%, and neither patient worry nor GP suspicion was seen in 18.2%. The highest likelihood of long PCI was observed in group 4 (group 4 vs. group 1: PPR 3.99 (95% CI 3.34-4.75)), mostly pronounced for easy-to-diagnose cancer types.

CONCLUSION: Misalignment between the patient's worry and the GP's suspicion was common at the first cancer-related encounter. Importance should be given to the patient interview, due to a potential delayed GP referral among patients diagnosed with "easy-to-diagnose" cancer types presenting with unspecific symptoms.

Keywords: Denmark; Early diagnosis; General practice; Neoplasms; Primary health care; Signs and symptoms

References

  1. Br J Cancer. 2009 Dec 3;101 Suppl 2:S92-S101 - PubMed
  2. Lancet. 1999 Apr 3;353(9159):1127-31 - PubMed
  3. Br J Gen Pract. 2020 Aug 27;70(698):e612-e621 - PubMed
  4. Cancer Epidemiol Biomarkers Prev. 2016 Jan;25(1):16-27 - PubMed
  5. Scand J Public Health. 2010 Nov;38(7):699-706 - PubMed
  6. Am J Epidemiol. 2011 Mar 15;173(6):676-82 - PubMed
  7. BMJ Qual Saf. 2020 Mar;29(3):198-208 - PubMed
  8. Lancet Oncol. 2012 Apr;13(4):353-65 - PubMed
  9. Scand J Public Health. 2011 Jul;39(7 Suppl):22-5 - PubMed
  10. BMJ Open. 2016 Jul 25;6(7):e009641 - PubMed
  11. Br J Cancer. 2009 Dec 3;101 Suppl 2:S80-6 - PubMed
  12. BMC Health Serv Res. 2009 Oct 19;9:189 - PubMed
  13. Health Policy. 2012 Apr;105(1):65-70 - PubMed
  14. Br J Gen Pract. 2019 Feb;69(679):e80-e87 - PubMed
  15. Br J Gen Pract. 2013 Sep;63(614):e627-35 - PubMed
  16. J R Coll Physicians Edinb. 2018 Sep;48(3):225-232 - PubMed
  17. Lancet Oncol. 2015 Sep;16(12):1231-72 - PubMed
  18. Br J Cancer. 2014 Jul 29;111(3):581-8 - PubMed
  19. Br J Gen Pract. 2018 Jul;68(672):e505-e511 - PubMed
  20. Scand J Public Health. 2011 Jul;39(7 Suppl):34-7 - PubMed
  21. PLoS One. 2013 Jul 22;8(7):e69700 - PubMed
  22. Br J Cancer. 2012 Oct 9;107(8):1220-6 - PubMed
  23. Lancet Oncol. 2019 Nov;20(11):1493-1505 - PubMed
  24. BMC Fam Pract. 2011 Sep 26;12:100 - PubMed
  25. Cancer Epidemiol. 2019 Apr;59:115-122 - PubMed
  26. Br J Cancer. 2015 Mar 31;112 Suppl 1:S35-40 - PubMed
  27. Clin Epidemiol. 2014 Jul 17;6:237-46 - PubMed
  28. Neoplasia. 2018 Feb;20(2):165-174 - PubMed
  29. Br J Cancer. 2009 Dec 3;101 Suppl 2:S5-8 - PubMed
  30. Eur J Cancer Care (Engl). 2021 May;30(3):e13411 - PubMed
  31. Heliyon. 2017 Jun 22;3(6):e00328 - PubMed
  32. Lancet. 2015 Mar 14;385(9972):977-1010 - PubMed
  33. Am J Epidemiol. 2004 Apr 1;159(7):702-6 - PubMed
  34. BMJ Open. 2018 Nov 27;8(11):e023870 - PubMed
  35. BJGP Open. 2017 Apr 05;1(2):bjgpopen17X100761 - PubMed
  36. Cancer Epidemiol. 2020 Apr;65:101690 - PubMed
  37. BMJ. 2014 Dec 09;349:g7400 - PubMed
  38. Nat Rev Clin Oncol. 2014 Jan;11(1):38-48 - PubMed
  39. Scand J Public Health. 2011 Jul;39(7 Suppl):30-3 - PubMed
  40. Br J Cancer. 2013 Feb 19;108(3):686-90 - PubMed
  41. BMC Fam Pract. 2008 May 18;9:31 - PubMed
  42. BMC Cancer. 2014 Aug 30;14:636 - PubMed
  43. Br J Cancer. 2012 Mar 27;106(7):1262-7 - PubMed
  44. Br J Cancer. 2005 Aug 22;93(4):399-405 - PubMed
  45. BMC Med Res Methodol. 2003 Oct 20;3:21 - PubMed
  46. Br J Gen Pract. 2009 Jun;59(563):441-5, 447; discussion 446 - PubMed
  47. Eur J Cancer Care (Engl). 2005 Dec;14(5):409-16 - PubMed
  48. Cancer Epidemiol. 2017 Jun;48:140-146 - PubMed

MeSH terms

Publication Types